Nigerians Health May Worsen On Poor Budgetary Allocation

Nigeria’s health service delivery could get worse in 2013 due to insignificant allocation in the 2013 budget awaiting Presidential assent, report has shown.

The report which examines innovative healthcare financing options in Nigeria, states that the N279 billion (5.7% of the 2013 total budget) allocation falls well below the internationally recommended minimum healthcare spend, to have an impact on the country’s healthcare delivery system.

The 2013 budget allocation to the healthcare sector, on a per capita basis, comes to N1, 680 as against a World Health Organisation (WHO) recommendation that governments spend a minimum of N6, 908 per head, on providing healthcare services to their citizens. The gap of N5, 224 per head at the Federation level is too wide to be filled by autonomous spending fr0m state governments, the report observes.

The 2013 budgetary allocation to healthcare delivery is made even worse by the fact that 77 percent or N77 of every N100 allocated to the Ministry, would be spent on paying personnel employed in the sector, leaving just N20 of every N100 spend, for capital expenditure incurred by over 50 Federal Medical Centres and Teaching hospitals across the federation and just N3 of every N100 budgeted for healthcare to cover overheads incurred.

With this structure of allocation, analysts observe that it is not surprising that these medical centres find it difficult to maintain existing facilities or acquire modern medical equipment. This explains the high tendency for political office holders and well to do Nigerians to travel abroad to take care of their healthcare needs, leaving Nigerians who cannot afford to travel abroad to use the poorly equipped and resourced hospitals in Nigeria.

Nigeria also has one of the lowest healthcare spends per head, even when compared with country peers in Africa. “South Africa spends about seven times more per head on healthcare than Nigeria does, while Angola spends about three times more per head than Nigeria.” The BusinessDay Reseach report is titled “Innovative Healthcare Financing in Nigeria: Challenges and Opportunities”.

Nigeria’s healthcare spend per head, which the 2012 World Health Statistics report puts at US$67, is even more insignificant, when compared with that of developed countries. The United States healthcare spend per head stands at $7000, that of Switzerland is US$6000 while the average healthcare spend per head among countries of the Organisation for Co-Operation and Development (OECD) is put at US$3,600.

A fallout of the low government spend on healthcare, is that Nigerians are forced to pay for healthcare delivery directly from their incomes at the point of getting healthcare services. This is classified as out of pocket expenses by the World Health Organisation (WHO), a major indicator of the state of healthcare delivery in a country.

The report shows that out of pocket expenses in Nigeria, which accounts for 65 percent of the total healthcare expenses in the country, is one of the highest in Africa. For example, out of pocket expense in Ghana is 29 percent, in South Africa it is just 17 percent, while it is just 10 percent in Angola. The danger of high out of pocket expenses is that it could lead to financial ruin, or in some tragic circumstances death, where the patient is unable to afford the immediate cost of healthcare.

Nigeria, the report shows, already has one of the worst healthcare statistics in Africa. An average of 143 children of every 1,000 births die before their fifth birthday in Nigeria, figures from the 2012 World Health Statistics show. The BusinessDay Research Report shows that the only place worse than Nigeria for a child to be born is Angola, among comparative countries. The African average is 119 for children dying before their fifth birthday. In Kenya, the average is 85, in Senegal 75, in Ghana 74 and in South Africa 57.

Nigeria also has one of the worse life expectancy rates for adult survivors of early childhood death. The average Nigerian had a life expectancy of just 54 years in 2009, just about the average in Africa, but well below 62 years for Senegal and 60 years for Ghana.